Association Of Dietary Sodium And Potassium Intakes With Depression In The Adults

Objective:The purpose of this study was to investigate the association between dietary sodium and dietary potassium intake and depression in adults using a cross-sectional data from the National Health and Nutrition Examination Survey?NHANES?.Methods:Data from the National Health and Nutrition Examination Survey?NHANES?2009-2010,2011-2012 and 2013-2014 were used in present study.Adults aged 18 years or older were included.Trained medical personnel conducted face-to-face questionnaires and physical examinations conducted by mobile testing centers to obtain general demographic information,dietary data,lifestyle information,disease history and other relevant data.Dietary data were obtained through two 24-hour dietary recall interview questionnaires,and depression was assessed using the Patient Health Questionnaire?PHQ-9?.To compare the difference in characteristics between the depression group and non-depression group,the Student's t-tests were used to compare the continuous variables if they obeyed the normal distribution,and the rank-sum test was used to compare the continuous variables if they did not obey the normal distribution.The distribution of the categorical variables between the two groups was compared by chi-square test.Dietary sodium and potassium intakes were categorized based on quartiles.Univariate and multivariate logistic regression analyses were conducted to evaluate the associations of dietary sodium and potassium intakes with depression.We evaluated the relationship between dietary sodium and potassium intakes and depression stratified by gender and energy intake.The dose-response relationships were explored by restricted cubic spline model.Dominance analysis was selected to investigate the relative importance of relative factors and depression.Results:A total of 13382 adult subjects aged 18 years or older were included in the present cross-sectional study,including 6570 males?49.10%?and 6812 females?50.90%?.1227people were assessed as depression,accounting for 9.17%of the total study subjects.Compared with the non-depressed group,the patients in the depression group were younger,and more likely to be obese,hypertensive,diabetic,and had a higher prevalence of female and smokers.Participants with depression had significantly lower education level,lower family income and lower work activity and recreational activity level.Univariate and multivariate logistic regression analysis showed that dietary sodium and potassium intakes were significantly negatively associated with depression.In model2,multivariate adjusted odds ratios?ORs?with 95%confidence intervals?CIs?of depression were 0.39?0.23,0.65?and 0.54?0.32,0.90?for the highest versus lowest quartile of dietary sodium and potassium intakes,respectively.In the stratified analyses,the inverse association between dietary sodium intake and depression was statistically significant in both males and females.There was gender difference between dietary potassium and depression.There was a significantly negative association among males,but no statistically significance among females.The results of the restricted cubic spline analyses found a linear dose-response relationship between dietary sodium and potassium intakes and depression(P_nonlinearity?29?0.05).Dominance analysis found that the relative important predictor for depression was family income?23%?,recreational activity?14%?,gender?10%?,smoking status?10%?,BMI?8%?,hypertension?6%?,educational level?6%?,dietary potassium intake?5%?,dietary sodium intake?4%?,diabetes?4%?,age?4%?,energy intake?3%?,alcohol consumption?1%?,race?1%?,work activity?0%?.Conclusion:The current study suggested that dietary sodium and potassium intakes may be associated with a reduced risk of depression.The results and related mechanisms need to be further studied and confirmed.